What Is COPD?
COPD, or chronic obstructive pulmonary (PULL-mun-ary) disease, is a progressive disease that makes it hard to breathe. "Progressive" means the disease gets worse over time.
COPD can cause coughing that produces large amounts of mucus (a slimy substance), wheezing, shortness of breath, chest tightness, and other symptoms.
Cigarette smoking is the leading cause of COPD. Most people who have COPD smoke or used to smoke. Long-term exposure to other lung irritants—such as air pollution, chemical fumes, or dust—also may contribute to COPD.
To understand COPD, it helps to understand how the lungs work. The air that you breathe goes down your windpipe into tubes in your lungs called bronchial (BRONG-ke-al) tubes or airways.
Within the lungs, your bronchial tubes branch into thousands of smaller, thinner tubes called bronchioles (BRONG-ke-ols). These tubes end in bunches of tiny round air sacs called alveoli (al-VEE-uhl-eye).
Small blood vessels called capillaries (KAP-ih-lare-ees) run through the walls of the air sacs. When air reaches the air sacs, oxygen passes through the air sac walls into the blood in the capillaries. At the same time, carbon dioxide (a waste gas) moves from the capillaries into the air sacs. This process is called gas exchange.
The airways and air sacs are elastic (stretchy). When you breathe in, each air sac fills up with air like a small balloon. When you breathe out, the air sacs deflate and the air goes out.
In COPD, less air flows in and out of the airways because of one or more of the following:
- The airways and air sacs lose their elastic quality.
- The walls between many of the air sacs are destroyed.
- The walls of the airways become thick and inflamed.
- The airways make more mucus than usual, which can clog them.
Normal Lungs and Lungs With COPD
In the United States, the term "COPD" includes two main conditions—emphysema (em-fih-SE-ma) and chronic bronchitis (bron-KI-tis). (Note: The Health Topics article about bronchitis discusses both acute and chronic bronchitis.)
In emphysema, the walls between many of the air sacs are damaged. As a result, the air sacs lose their shape and become floppy. This damage also can destroy the walls of the air sacs, leading to fewer and larger air sacs instead of many tiny ones. If this happens, the amount of gas exchange in the lungs is reduced.
In chronic bronchitis, the lining of the airways is constantly irritated and inflamed. This causes the lining to thicken. Lots of thick mucus forms in the airways, making it hard to breathe.
Most people who have COPD have both emphysema and chronic bronchitis. Thus, the general term "COPD" is more accurate.
COPD is a major cause of disability, and it's the third leading cause of death in the United States. Currently, millions of people are diagnosed with COPD. Many more people may have the disease and not even know it.
COPD develops slowly. Symptoms often worsen over time and can limit your ability to do routine activities. Severe COPD may prevent you from doing even basic activities like walking, cooking, or taking care of yourself.
Most of the time, COPD is diagnosed in middle-aged or older adults. The disease isn't passed from person to person—you can't catch it from someone else.
COPD has no cure yet, and doctors don't know how to reverse the damage to the airways and lungs. However, treatments and lifestyle changes can help you feel better, stay more active, and slow the progress of the disease.
Other Names for COPD
COPD (Chronic Obstructive Pulmonary Disease) - Overview
What is chronic obstructive pulmonary disease (COPD)?
COPD is a lung disease that makes it hard to breathe. It is caused by damage to the lungs over many years, usually from smoking.
COPD is often a mix of two diseases:
- Chronic bronchitis (say "bron-KY-tus"). In chronic bronchitis, the airways that carry air to the lungs (bronchial tubes ) get inflamed and make a lot of mucus. This can narrow or block the airways, making it hard for you to breathe.
- Emphysema (say "em-fuh-ZEE-muh"). In a healthy person, the tiny air sacs in the lungs are like balloons. As you breathe in and out, they get bigger and smaller to move air through your lungs. But with emphysema, these air sacs are damaged and lose their stretch. Less air gets in and out of the lungs, which makes you feel short of breath.
COPD gets worse over time. You can't undo the damage to your lungs. But you can take steps to prevent more damage and to feel better.
What causes COPD?
COPD is almost always caused by smoking. Over time, breathing tobacco smoke irritates the airways and destroys the stretchy fibers in the lungs.
Other things that may put you at risk include breathing chemical fumes, dust, or air pollution over a long period of time. Secondhand smoke is also bad.
It usually takes many years for the lung damage to start causing symptoms, so COPD is most common in people who are older than 60.
You may be more likely to get COPD if you had a lot of serious lung infections when you were a child. People who get emphysema in their 30s or 40s may have a disorder that runs in families, called alpha-1 antitrypsin deficiency. But this is rare.
What are the symptoms?
The main symptoms are:
- A long-lasting (chronic) cough.
- Mucus that comes up when you cough.
- Shortness of breath that gets worse when you exercise.
As COPD gets worse, you may be short of breath even when you do simple things like get dressed or fix a meal. It gets harder to eat or exercise, and breathing takes much more energy. People often lose weight and get weaker.
At times, your symptoms may suddenly flare up and get much worse. This is called a COPD exacerbation (say "egg-ZASS-er-BAY-shun"). An exacerbation can range from mild to life-threatening. The longer you have COPD, the more severe these flare-ups will be.
How is COPD diagnosed?
To find out if you have COPD, a doctor will:
- Do a physical exam and listen to your lungs.
- Ask you questions about your past health and whether you smoke or have been exposed to other things that can irritate your lungs.
- Have you do breathing tests, including spirometry, to find out how well your lungs work.
- Do chest X-rays and other tests to help rule out other problems that could be causing your symptoms.
COPD (Chronic Obstructive Pulmonary Disease) - Overview
If there is a chance you could have COPD, it is very important to find out as soon as you can. This gives you time to take steps to slow the damage to your lungs.
How is it treated?
The best way to slow COPD is to quit smoking. This is the most important thing you can do. It is never too late to quit. No matter how long you have smoked or how serious your COPD is, quitting smoking can help stop the damage to your lungs.
It's hard to quit smoking. Talk to your doctor about treatments that can help. You will double your chances of quitting even if medicine is the only treatment you use to quit, but your odds get even better when you combine medicine and other quit strategies, such as counseling.1 To learn more about how to quit, go to www.smokefree.gov, or call 1-800-QUITNOW (1-800-784-8669).
Your doctor can prescribe treatments that may help you manage your symptoms and feel better.
- Medicines can help you breathe easier. Most of them are inhaled so they go straight to your lungs. If you get an inhaler, it is very important to use it just the way your doctor shows you.
- A lung (pulmonary) rehab program can help you learn to manage your disease. A team of health professionals can provide counseling and teach you how to breathe easier, exercise, and eat well.
- In time, you may need to use oxygen some or most of the time.
People who have COPD are more likely to get lung infections, so you will need to get a flu vaccine every year. You should also get a pneumococcal shot. It may not keep you from getting pneumonia. But if you do get pneumonia, you probably will not be as sick.
There are many things you can do at home to stay as healthy as you can.
- Avoid things that can irritate your lungs, such as smoke, pollution, and air that is cold and dry.
- Use an air conditioner or air filter in your home.
- Take rest breaks during the day.
- Get regular exercise to stay as strong as you can.
- Eat well so you can keep up your strength. If you are losing weight, ask your doctor or dietitian about ways to make it easier to get the calories you need.